Treatment for tongue carcinoma by interstitial radiotherapy simultaneously combined with continuous chemotherapy

为提高舌癌原发灶的局部控制率和预防转移，应用持续注射培霉素同时联合间质放疗治疗舌癌原发灶。本研究以39例舌鳞状细胞癌为研究对象，其中试验组8例，对照组8例。试验组间质放疗期间连续给予培霉素总剂量10-15mg，剂量为2-3mg / d。在第一次放射治疗之前，静脉给予另外5mg培霉素。两组的辐射剂量约为每48-144小时60戈瑞。两组局部控制率及治疗结束后至少3个月生存率基本相同。试验组T2患者首次登记时仅有1例颈部淋巴结转移。治疗后4 ~ 6个月，共有3例患者出现局部淋巴结转移，其中试验组1例，对照组2例。5例均行根治性颈部清扫术。所有病例均未发现远处转移。在治疗期间和治疗后粘膜反应的过程中，试验组黄斑完全消失有延迟的趋势。由于病例数和观察期有限，迄今两组间无明显差异。在局部控制率和转移发生率方面的阳性结果将通过持续的长期随访得到期待。

For the improvement of local control rate and the prevention of metastasis a continuous injection of Peplomycin simultaneously combined with interstitial radiotherapy was applied for the treatment of the primary lesion of tongue carcinoma. Thirty-nine fresh cases of squamous cell carcinomas of the tongue were put into this study, 8 of them were in the trial group and the others were the control. For the trial group total 10-15mg of Peplomycin were administered continuously during the period of the interstitial radiotherapy with the rate of 2-3mg per day. Prior to the inters titial radiotherapy another 5mg of Peplomycin were given intravenously. The dose of radiation was approximately 60 Gy per 48-144 hours in both groups. The local control rate and the survival rate at least 3 months after the completion of the treatment were almost the same in both groups. Only a case of T2 in the trial group was of cervical lymphnode metastasis at the first registration. The metastases to the regional lymphnode were found in total 3 cases, 1 in the trial group and 2 in the control group during 4 to 6 months after the treatment. Radical neck dissection was performed in all 5 cases. No distant metastasis was found in all cases. As to the course of mucosal reaction during and after the treatment, a complete disappearance of yellow plaque tended to delay in the trial group. Because of the limited case number and observation period there found no remerkable difference between 2 groups up to date. The positive resalts in the local control rate and the incidence of metastasis will be expected by continuing long term follow-up.